Archives of Osteoporosis

, 9:183 | Cite as

Bone microarchitecture and strength of the radius and tibia in a reference population of young adults: an HR-pQCT study

  • Lauren A. BurtEmail author
  • Heather M. Macdonald
  • David A. Hanley
  • Steven K. Boyd
Original Article



Within a normative youth cohort (16–29 years) bone parameters for males and females remained stable at the radius. At the tibia, a peak was observed for females at 16–19 years, with bone density and strength decreasing by 29 years.


To determine if bone microstructural and strength parameters identified by high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA) at the distal radius and tibia, peak within the age range of this youth cohort, and whether the timing of the peaks differ based on sex or skeletal site.


We recruited 251 participants (158 female; 16 to 29 years), grouping them into 5-year age brackets (16–19; 20–24; 25–29 years) assessing microstructural and strength parameters with HR-pQCT and FEA.


HR-pQCT assessment of males and females (age-matched groups) showed males had higher total area and BMD, trabecular BMD and trabecular number (radius only) cortical thickness and porosity, and failure load, but lower cortical BMD (p < 0.05). Within sex, microstructural and strength parameters remained stable for males, but in females they appeared to peak at 16–19 years at the tibia. Tibia bone strength and trabecular BMD were highest in females 16–19 years (p < 0.05), and tibia cortical porosity was lowest in females 16–19 years (p < 0.001). With the exception of an age-related increase in cortical BMD, all other parameters were stable between 16 and 29 years at the radius for both males and females. We found no peak values for males or females at the radius. At the tibia, a peak was observed for females 16–19 years.


These data provide a population-based assessment of bone microstructural and strength parameters from HR-pQCT and FEA in a youth cohort, showing clear differences in bone quality dependent on sex and skeletal site.


High-resolution peripheral quantitative computed tomography Bone strength Finite element analysis Peak bone mass 



The authors would like to thank all the participants who graciously devoted time to participate in the study, Michelle Kan for scan acquisition, and Jane Allan and Bernice Love for their assistance in participant recruitment and administering the extensive interview-based questionnaire.

This study was funded by the Canadian Institutes of Health Research (CIHR) MOP-106611.

Conflicts of interest

Lauren A Burt, Heather M Macdonald, David A Hanley and Steven K Boyd declare that they have no conflict of interest.


  1. 1.
    Baxter-Jones AD, Faulkner RA, Forwood MR, Mirwald RL, Bailey DA (2011) Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J Bone Miner Res 26(8):1729–1739PubMedCrossRefGoogle Scholar
  2. 2.
    Faulkner R, Bailey D (2007) Osteoporosis: a pediatric concern? Med Sports Sci 51:1–12CrossRefGoogle Scholar
  3. 3.
    Boot AM, de Ridder MA, van der Sluis IM, van Slobbe I, Krenning EP, de Muinck Keizer-Schrama SM (2010) Peak bone mineral density, lean body mass and fractures. Bone 46(2):336–341PubMedCrossRefGoogle Scholar
  4. 4.
    Lorentzon M, Mellström D, Ohlsson C (2005) Age of attainment of peak bone mass is site specific in Swedish men—the GOOD study. J Bone Miner Res 20(7):1223–1227PubMedCrossRefGoogle Scholar
  5. 5.
    Lu PW, Briody JN, Ogle GD, Morley K, Humphries IR, Allen J, Howman-Giles R, Sillence D, Cowell CT (1994) Bone mineral density of total body, spine, and femoral neck in children and young adults: a cross-sectional and longitudinal study. J Bone Miner Res 9(9):1451–1458PubMedCrossRefGoogle Scholar
  6. 6.
    Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, Andon MB, Smith KT, Heaney RP (1994) Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest 93(2):799–808PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Wren TA, Kim PS, Janicka A, Sanchez M, Gilsanz V (2007) Timing of peak bone mass: discrepancies between CT and DXA. J Clin Endocrinol Metab 92(3):938–941PubMedCrossRefGoogle Scholar
  8. 8.
    Berger C, Goltzman D, Langsetmo L, Joseph L, Jackson S, Kreiger N, Tenenhouse A, Davison KS, Josse RG, Prior JC (2010) Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res 25(9):1948–1957PubMedCrossRefGoogle Scholar
  9. 9.
    Lin Y-C, Lyle R, Weaver C, McCabe L, McCabe G, Johnston C, Teegarden D (2003) Peak spine and femoral neck bone mass in young women. Bone 32(5):546–553PubMedCrossRefGoogle Scholar
  10. 10.
    Hernandez CJ, Beaupre GS, Carter DR (2003) A theoretical analysis of the relative influences of peak BMD, age-related bone loss and menopause on the development of osteoporosis. Osteoporos Int 14(10):843–847PubMedCrossRefGoogle Scholar
  11. 11.
    Schonau E (2004) The peak bone mass concept: is it still relevant? Pediatr Nephrol 19(8):825–831PubMedCrossRefGoogle Scholar
  12. 12.
    Vilayphiou N, Boutroy S, Sornay-Rendu E, Munoz F, Delmas PD, Chapurlat R (2010) Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in postmenopausal women. Bone 46(4):1030–1037PubMedCrossRefGoogle Scholar
  13. 13.
    Vilayphiou N, Boutroy S, Szulc P, van Rietbergen B, Munoz F, Delmas PD, Chapurlat R (2011) Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in men. J Bone Miner Res 26(5):965–973PubMedCrossRefGoogle Scholar
  14. 14.
    Nishiyama K, Macdonald H, Hanley D, Boyd S (2012) Women with previous fragility fractures can be classified based on bone microarchitecture and finite element analysis measured with HR-pQCT. Osteoporosis Int 24(5):1733–1740CrossRefGoogle Scholar
  15. 15.
    Burrows M, Liu D, McKay H (2010) High-resolution peripheral QCT imaging of bone micro-structure in adolescents. Osteoporosis Int 21(3):515–520CrossRefGoogle Scholar
  16. 16.
    Burrows M, Liu D, Moore S, McKay H (2010) Bone microstructure at the distal tibia provides a strength advantage to males in late puberty: an HR-pQCT study. J Bone Miner Res 25(6):1423–1432PubMedGoogle Scholar
  17. 17.
    Kirmani S, Christen D, van Lenthe GH, Fischer PR, Bouxsein ML, McCready LK, Melton LJ, Riggs BL, Amin S, Müller R (2009) Bone structure at the distal radius during adolescent growth. J Bone Miner Res 24(6):1033–1042PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Nishiyama KK, Macdonald HM, Moore SA, Fung T, Boyd SK, McKay HA (2012) Cortical porosity is higher in boys compared with girls at the distal radius and distal tibia during pubertal growth: an HR-pQCT study. J Bone Miner Res 27(2):273–282PubMedCrossRefGoogle Scholar
  19. 19.
    Wang Q, Wang XF, Iuliano-Burns S, Ghasem-Zadeh A, Zebaze R, Seeman E (2010) Rapid growth produces transient cortical weakness: a risk factor for metaphyseal fractures during puberty. J Bone Miner Res 25(7):1521–1526PubMedCrossRefGoogle Scholar
  20. 20.
    Dalzell N, Kaptoge S, Morris N, Berthier A, Koller B, Braak L, van Rietbergen B, Reeve J (2009) Bone micro-architecture and determinants of strength in the radius and tibia: age-related changes in a population-based study of normal adults measured with high-resolution pQCT. Osteoporosis Int 20(10):1683–1694CrossRefGoogle Scholar
  21. 21.
    Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, Peterson JM, Melton LJ (2006) Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res 21(1):124–131PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Macdonald HM, Nishiyama KK, Kang J, Hanley DA, Boyd SK (2011) Age–related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population-based HR-pQCT study. J Bone Miner Res 26(1):50–62PubMedCrossRefGoogle Scholar
  23. 23.
    Zhou W, Langsetmo L, Berger C, Adachi JD, Papaioannou A, Ioannidis G, Webber C, Atkinson SA, Olszynski WP, Brown JP (2010) Normative bone mineral density z-scores for Canadians aged 16 to 24 years: the Canadian Multicenter Osteoporosis Study. J Clin Densitom 13(3):267–276PubMedCrossRefGoogle Scholar
  24. 24.
    Kreiger N, Tenenhouse A, Joseph L, Mackenzie T, Poliquin S, Brown JP, Prior JC, Rittmaster RS (1999) Research notes: the Canadian multicentre osteoporosis study (CaMos): background, rationale, methods. Can J Aging 18(03):376–387CrossRefGoogle Scholar
  25. 25.
    Tenenhouse A, Kreiger N, Hanley D (2000) Canadian multicentre osteoporosis study (CaMos). Drug Dev Res 49(3):201–205CrossRefGoogle Scholar
  26. 26.
    Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90(12):6508–6515PubMedCrossRefGoogle Scholar
  27. 27.
    Pauchard Y, Liphardt AM, Macdonald HM, Hanley DA, Boyd SK (2012) Quality control for bone quality parameters affected by subject motion in high-resolution peripheral quantitative computed tomography. Bone 50(6):1304–1310PubMedCrossRefGoogle Scholar
  28. 28.
    Buie HR, Campbell GM, Klinck RJ, MacNeil JA, Boyd SK (2007) Automatic segmentation of cortical and trabecular compartments based on a dual threshold technique for in vivo micro-CT bone analysis. Bone 41(4):505–515PubMedCrossRefGoogle Scholar
  29. 29.
    Burghardt AJ, Buie HR, Laib A, Majumdar S, Boyd SK (2010) Reproducibility of direct quantitative measures of cortical bone microarchitecture of the distal radius and tibia by HR-pQCT. Bone 47(3):519–528PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK (2010) Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res 25(4):882–890PubMedGoogle Scholar
  31. 31.
    Burghardt AJ, Kazakia GJ, Ramachandran S, Link TM, Majumdar S (2010) Age-and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. J Bone Miner Res 25(5):983–993PubMedCentralPubMedGoogle Scholar
  32. 32.
    MacNeil JA, Boyd SK (2008) Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method. Bone 42(6):1203–1213PubMedCrossRefGoogle Scholar
  33. 33.
    Pistoia W, Van Rietbergen B, Lochmüller E-M, Lill C, Eckstein F, Rüegsegger P (2002) Estimation of distal radius failure load with micro-finite element analysis models based on three-dimensional peripheral quantitative computed tomography images. Bone 30(6):842–848PubMedCrossRefGoogle Scholar
  34. 34.
    Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8(5):468–489PubMedCrossRefGoogle Scholar
  35. 35.
    Looker AC, Melton L III, Borrud L, Shepherd J (2012) Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. Osteoporos Int 23(4):1351–1360PubMedCrossRefGoogle Scholar
  36. 36.
    Watts NB, Leslie WD, Foldes AJ, Miller PD (2013) 2013 International Society for Clinical Densitometry Position Development Conference: task force on normative databases. J Clin Densitom 16(4):472–481PubMedCrossRefGoogle Scholar
  37. 37.
    Burghardt AJ, Kazakia GJ, Ramachandran S, Link TM, Majumdar S (2010) Age- and gender-related differences in the geometric properties and biomechanical significance of intracortical porosity in the distal radius and tibia. J Bone Miner Res 25(5):983–993PubMedCentralPubMedGoogle Scholar
  38. 38.
    Duren DL, Seselj M, Froehle AW, Nahhas RW, Sherwood RJ (2013) Skeletal growth and the changing genetic landscape during childhood and adulthood. Am J Phys Anthropol 150(1):48–57PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Gordon CL, Halton JM, Atkinson SA, Webber CE (1991) The contributions of growth and puberty to peak bone mass. Growth Dev Aging 55(4):257–262PubMedGoogle Scholar
  40. 40.
    Tanner JM, Whitehouse RH, Hughes PC, Carter BS (1976) Relative importance of growth hormone and sex steroids for the growth at puberty of trunk length, limb length, and muscle width in growth hormone-deficient children. J Pediatr 89(6):1000–1008PubMedCrossRefGoogle Scholar
  41. 41.
    Garn SM (1970) The earlier gain and the later loss of cortical bone, in nutritional perspective. Thomas, SpringfieldGoogle Scholar
  42. 42.
    Schoenau E, Neu C, Rauch F, Manz F (2002) Gender-specific pubertal changes in volumetric cortical bone mineral density at the proximal radius. Bone 31(1):110–113PubMedCrossRefGoogle Scholar
  43. 43.
    Schoenau E, Neu C, Mokov E, Wassmer G, Manz F (2000) Influence of puberty on muscle area and cortical bone area of the forearm in boys and girls. J Clin Endocrinol Metab 85(3):1095–1098PubMedCrossRefGoogle Scholar
  44. 44.
    Seeman E (2001) Sexual dimorphism in skeletal size, density, and strength. J Clin Endocrinol Metab 86(10):4576–4584PubMedCrossRefGoogle Scholar
  45. 45.
    Turner CH, Burr DB (1993) Basic biomechanical measurements of bone: a tutorial. Bone 14(4):595–608PubMedCrossRefGoogle Scholar
  46. 46.
    Augat P, Schorlemmer S (2006) The role of cortical bone and its microstructure in bone strength. Age and ageing 35(2):ii27–ii31PubMedGoogle Scholar
  47. 47.
    Wachter NJ, Augat P, Krischak GD, Mentzel M, Kinzl L, Claes L (2001) Prediction of cortical bone porosity In Vitro by microcomputed tomography. Calcif Tissue Int 68(1):38–42PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  • Lauren A. Burt
    • 1
    Email author
  • Heather M. Macdonald
    • 2
  • David A. Hanley
    • 3
  • Steven K. Boyd
    • 1
  1. 1.Department of Radiology, Faculty of Medicine, McCaig Institute for Bone and Joint HealthUniversity of CalgaryCalgaryCanada
  2. 2.Department of Orthopaedics, Child & Family Research InstituteUniversity of British ColumbiaVancouverCanada
  3. 3.Departments of Medicine, Community Health Sciences, and Oncology, McCaig Institute of Bone and Joint HealthUniversity of CalgaryCalgaryCanada

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